The diaphragm it is the main muscle involved in breathing and serves as a barrier between the thorax and the abdominal cavity. As with any organ or muscle, the diaphragm is subject to disorders and abnormalities, which come in many different forms and may result from injury or disease. Diseases of the diaphragm can cause breathing problems. These conditions are often present at birth or form as a result of injury, accident or surgery.

Thoracic surgeon Dr. Michalis Klimatsidas in collaboration with doctors, nurses and rehabilitation specialists at the Agios Loukas Clinic in Panorama, Thessaloniki, aims to develop an individualized treatment plan for each patient facing a diaphragmatic disease. Together with his team, he offers minimally invasive thoracoscopic (VATS) and (RATS) robotics options for all diaphragm surgeries, to shorten the patient's hospitalization and recovery time.

There are several disorders that can affect the diaphragm, including:

→ Congenital hiatal hernia: Before birth, a hole in the diaphragm allows the baby's digestive organs to move into the chest cavity, reducing lung space and causing breathing problems.

→ Acquired hiatal hernia: Blunt trauma, stab wounds, or gunshot wounds can cause a hole to develop in the diaphragm that allows the digestive organs to move into the chest cavity and interfere with breathing.

→ Hiatal hernia: Part of the stomach pushes up through the diaphragm into the esophagus, leading to acid reflux.

→ Diaphragmatic volume: Tumors that start in the diaphragm are rare and often benign. Tumors can also appear in the diaphragm after metastasis (spread) from the lungs or liver.

→ Paralysis of the diaphragm: When the phrenic nerve is injured, one or both sides of the diaphragm may become paralyzed, compromising lung function.

Treatment of diseases of the diaphragm

Diaphragmatic disorders can have a variety of causes, depending on the type of disorder, ranging from being present at birth to severe trauma. We work with each patient to make the most appropriate treatment decision, which may include one or more of these treatments: medication, oxygen therapy, surgically implantable diaphragm pacemaker, tracheostomy and mechanical ventilator, or even watchful waiting and evaluation if the symptoms are not serious.

The surgery it is often necessary to treat diaphragmatic paralysis, abnormal elevation or shape, or hernia.

The following operations are performed:

→ Diaphragm breakdown: The diaphragm is pressed against the abdomen and two rows of sutures are sewn on each side of the edge of the diaphragm where it meets the chest wall. The suture is tied in place, creating a crease in the diaphragm, tightening and lowering the diaphragm into the abdomen.

→ Hiatal hernia repair: The hernia is closed with sutures to restore the integrity of the diaphragm and prevent abdominal organs from entering the chest cavity.

→ Paralysis of the diaphragm :Our team is in the process of being able to implant external diaphragm pacing which will help a special and difficult group of patients who are currently ventilator dependent. 

RAISING the diaphragm  Currently, the above condition is successfully treated with the operation called robotic plication of the diaphragm (Robotic Plication of Diaphragm).

For more information and clarifications or to schedule an appointment, you can contact Dr. Michalis Klimatsidas by calling (+030) 6944562928 or by filling out the relevant form.